Why are my eyebrows thinning on the outer edges?

Outer eyebrow thinning often signals thyroid dysfunction, particularly hypothyroidism, but can also result from nutritional deficiencies, hormonal changes, or autoimmune conditions. Getting comprehensive blood work including thyroid panels can help identify the underlying cause and guide treatment.

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Understanding Outer Eyebrow Thinning

If you've noticed your eyebrows becoming sparse, particularly on the outer third, you're experiencing a condition that dermatologists call madarosis. This specific pattern of hair loss, where the tail end of your eyebrows gradually disappears, is more than just a cosmetic concern. It's often your body's way of signaling an underlying health issue that needs attention.

The loss of the lateral third of the eyebrow, sometimes called the 'Queen Anne's sign' or 'Hertoghe's sign,' has been recognized as a clinical indicator for over a century. While it's normal to lose a few eyebrow hairs daily as part of the natural hair growth cycle, progressive thinning that creates a shortened or incomplete eyebrow appearance warrants investigation.

Understanding why this happens requires looking at multiple body systems, from your thyroid and hormones to your nutritional status and immune function. The good news is that once you identify the root cause through proper testing, many cases of eyebrow thinning are reversible with appropriate treatment.

Common Causes of Outer Eyebrow Thinning

Multiple conditions can cause eyebrow thinning. Comprehensive testing helps identify the specific cause for targeted treatment.
ConditionKey SignsAssociated SymptomsTesting Needed
HypothyroidismHypothyroidismOuter third loss (Queen Anne's sign)Fatigue, weight gain, cold intolerance, dry skinTSH, Free T3, Free T4, TPOAb
Iron DeficiencyIron DeficiencyDiffuse thinning, brittle textureFatigue, pale skin, brittle nails, hair lossFerritin, CBC, Iron panel
PCOSPCOSThinning with facial hair growthIrregular periods, acne, weight gainTestosterone, DHEA-S, LH, FSH
Alopecia AreataAlopecia AreataPatchy, sudden lossPossible scalp patches, nail pittingClinical diagnosis, possible biopsy

Multiple conditions can cause eyebrow thinning. Comprehensive testing helps identify the specific cause for targeted treatment.

The Thyroid Connection: Your Primary Suspect

The most common medical cause of outer eyebrow thinning is hypothyroidism, a condition where your thyroid gland doesn't produce enough thyroid hormones. The thyroid hormones T3 and T4 play crucial roles in regulating hair follicle function and the hair growth cycle. When these hormone levels drop, hair follicles can prematurely enter the resting phase and eventually stop producing hair altogether.

How Thyroid Hormones Affect Hair Growth

Thyroid hormones directly influence the hair growth cycle by regulating the metabolism of cells in hair follicles. They help control the transition between growth (anagen), regression (catagen), and resting (telogen) phases. In hypothyroidism, follicles spend more time in the telogen phase and less time actively growing, leading to progressive thinning. The outer eyebrows are particularly sensitive to these changes, often showing signs before scalp hair is noticeably affected.

Research published in the International Journal of Trichology found that up to 50% of patients with hypothyroidism experience some form of hair loss, with eyebrow madarosis being one of the earliest and most specific signs. If you're experiencing outer eyebrow thinning along with other symptoms like fatigue, weight gain, cold intolerance, or dry skin, comprehensive thyroid testing should be your first step.

Beyond TSH: Complete Thyroid Testing

While many doctors only test TSH (Thyroid Stimulating Hormone), this single marker can miss subtle thyroid dysfunction. For a complete picture, you need to test TSH along with Free T3, Free T4, and thyroid antibodies (TPOAb). These additional markers can reveal conditions like subclinical hypothyroidism, thyroid hormone conversion issues, or autoimmune thyroid disease (Hashimoto's thyroiditis) that might not show up on TSH alone.

Nutritional Deficiencies That Target Your Brows

Your hair follicles are metabolically active and require a steady supply of nutrients to function properly. Several key nutritional deficiencies can manifest as eyebrow thinning, particularly affecting the more vulnerable outer portions.

Iron Deficiency and Ferritin Levels

Iron deficiency is the second most common cause of hair loss after thyroid dysfunction. Your body needs iron to produce hemoglobin, which carries oxygen to hair follicles. Without adequate oxygen supply, follicles can't maintain normal growth cycles. Ferritin, the storage form of iron, is particularly important. Studies suggest that ferritin levels below 70 ng/mL can contribute to hair loss, even if you're not technically anemic.

A 2013 study in the Journal of Korean Medical Science found that women with hair loss had significantly lower ferritin levels compared to controls, with many showing improvement after iron supplementation. The researchers noted that eyebrow hair was often the first to respond to treatment, sometimes before scalp hair showed improvement.

B Vitamins and Biotin

B vitamins, particularly biotin (B7), folate (B9), and B12, are essential for healthy hair growth. Biotin deficiency, though rare in people eating a balanced diet, can occur in those taking certain medications, during pregnancy, or with digestive disorders. Signs include thinning eyebrows, brittle nails, and a scaly red rash around the eyes and mouth. Vitamin B12 deficiency, more common in vegetarians, older adults, and those with absorption issues, can also contribute to premature hair loss and graying.

Vitamin D: The Sunshine Vitamin

Vitamin D receptors are present in hair follicles, and this vitamin plays a role in creating new hair follicles and maintaining the hair growth cycle. Low vitamin D levels have been linked to various forms of hair loss, including alopecia areata, which can affect eyebrows. With many people spending more time indoors and using sunscreen religiously, vitamin D deficiency has become increasingly common.

Hormonal Imbalances Beyond the Thyroid

While thyroid issues are the most common hormonal cause of eyebrow thinning, other hormonal imbalances can also affect eyebrow density and growth patterns.

Androgens and PCOS

In women, elevated androgens (male hormones) can cause a paradoxical effect: hair loss on the scalp and eyebrows while promoting hair growth in unwanted areas like the face and body. This pattern is common in Polycystic Ovary Syndrome (PCOS), affecting up to 10% of women of reproductive age. The elevated testosterone and DHEA-S levels in PCOS can miniaturize hair follicles, leading to progressive thinning.

If you're experiencing eyebrow thinning along with irregular periods, acne, or unwanted facial hair growth, comprehensive hormone testing can help identify whether PCOS or other androgen-related conditions are contributing to your symptoms.

Estrogen and Menopause

The decline in estrogen during perimenopause and menopause can significantly impact hair growth, including eyebrow density. Estrogen helps keep hair in the growth phase longer, so when levels drop, hair may shed more quickly and grow back more slowly or sparsely. Many women notice their eyebrows becoming thinner and requiring more maintenance during this transition.

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Autoimmune and Skin Conditions

Several autoimmune and inflammatory conditions can specifically target hair follicles, leading to eyebrow loss. Alopecia areata, an autoimmune condition where the immune system attacks hair follicles, can cause patchy hair loss anywhere on the body, including the eyebrows. When it affects only the eyebrows, it's called alopecia areata of the eyebrows.

Atopic dermatitis (eczema) and seborrheic dermatitis can also affect the eyebrow area, causing inflammation that disrupts normal hair growth. Contact dermatitis from cosmetics or skincare products is another potential culprit. If you notice redness, scaling, or itching along with hair loss, a dermatological evaluation may be necessary.

Frontal fibrosing alopecia, a condition that causes scarring hair loss along the hairline, often affects the eyebrows as well. This condition is more common in postmenopausal women and requires prompt treatment to prevent permanent hair loss.

Lifestyle Factors and External Causes

Sometimes, eyebrow thinning isn't due to an internal health issue but rather external factors and habits that damage hair follicles over time.

  • Over-plucking or waxing: Repeated trauma to hair follicles can eventually cause permanent damage, preventing regrowth
  • Aggressive makeup removal: Rubbing too hard when removing eye makeup can cause mechanical damage to delicate eyebrow hairs
  • Chemical exposure: Harsh skincare ingredients like retinoids or chemical peels that migrate to the eyebrow area
  • Nutritional restrictions: Very low-calorie diets or eating disorders can deprive follicles of essential nutrients
  • Medications: Certain drugs including chemotherapy agents, blood thinners, and some antidepressants can cause hair loss
  • Stress: Chronic psychological stress can trigger telogen effluvium, causing widespread hair shedding including eyebrows

Getting to the Root Cause: Essential Testing

To determine why your eyebrows are thinning, comprehensive blood testing is essential. A thorough evaluation should include thyroid function (TSH, Free T3, Free T4, and TPOAb), nutritional markers (ferritin, vitamin D, B12, folate), and hormone levels appropriate for your age and sex.

For a complete metabolic and hormonal assessment, consider testing that includes inflammatory markers like hs-CRP, metabolic markers like glucose and HbA1c, and a full hormone panel. Many of these imbalances are interconnected, and addressing one without considering the others may not fully resolve the issue.

If you're experiencing eyebrow thinning and want to understand your body's unique biochemistry, you can also upload your existing blood test results to SiPhox Health's free analysis service for personalized insights and recommendations based on your biomarker data.

Treatment Approaches and Recovery Timeline

Once you've identified the underlying cause, targeted treatment can often restore eyebrow growth. The approach will depend on your specific diagnosis, but here are common interventions and what to expect.

Medical Treatments

For thyroid dysfunction, thyroid hormone replacement therapy can restore normal hair growth cycles. Most patients see improvement in eyebrow density within 3-6 months of achieving optimal thyroid levels. Iron supplementation for deficiency typically shows results in 2-4 months, though it's important to retest levels regularly to avoid iron overload.

Topical treatments like minoxidil (Rogaine) can stimulate eyebrow growth regardless of the underlying cause. Applied twice daily to the eyebrow area, it can produce visible results in 8-16 weeks. For autoimmune conditions, corticosteroid injections or topical immunotherapy may be necessary.

Natural Support Strategies

  • Castor oil: Rich in ricinoleic acid, may improve circulation to follicles when massaged into eyebrows nightly
  • Proper nutrition: Ensure adequate protein intake (0.8-1g per kg body weight) and consider a multivitamin
  • Stress management: Regular exercise, meditation, or yoga can help normalize cortisol levels
  • Gentle care: Avoid harsh rubbing, use a spoolie brush to stimulate circulation, and remove makeup gently
  • Patience: Hair growth cycles mean it takes 3-4 months to see significant improvement with any treatment

When Eyebrow Thinning Signals Something Serious

While eyebrow thinning is usually benign and treatable, certain patterns warrant immediate medical attention. Sudden, complete loss of eyebrow hair, especially if accompanied by scalp hair loss, could indicate an acute medical condition or severe nutritional deficiency. Eyebrow loss with skin changes like thickening, discoloration, or nodules might suggest an infiltrative disorder or infection.

If you experience eyebrow thinning along with unexplained weight loss, fever, night sweats, or other systemic symptoms, see your healthcare provider promptly. These could be signs of an underlying condition requiring immediate treatment.

Taking Action for Healthier Eyebrows

Outer eyebrow thinning might seem like a small cosmetic issue, but it's often your body's way of alerting you to an underlying imbalance. By taking it seriously and investigating the root cause through comprehensive testing, you're not just addressing the symptom but potentially uncovering and treating conditions that affect your overall health and wellbeing.

Remember that eyebrow regrowth takes time, typically 3-6 months once the underlying issue is addressed. Be patient with the process and consistent with your treatment plan. With the right diagnosis and intervention, most people can restore their eyebrows to their former fullness while improving their overall health in the process.

References

  1. Patel, D. P., Swink, S. M., & Castelo-Soccio, L. (2017). A Review of the Use of Biotin for Hair Loss. Skin Appendage Disorders, 3(3), 166-169.[PubMed][DOI]
  2. Guo, E. L., & Katta, R. (2017). Diet and hair loss: effects of nutrient deficiency and supplement use. Dermatology Practical & Conceptual, 7(1), 1-10.[PubMed][DOI]
  3. Vincent, M., & Yogiraj, K. (2013). A Descriptive Study of Alopecia Patterns and their Relation to Thyroid Dysfunction. International Journal of Trichology, 5(1), 57-60.[PubMed][DOI]
  4. Park, S. Y., Na, S. Y., Kim, J. H., Cho, S., & Lee, J. H. (2013). Iron plays a certain role in patterned hair loss. Journal of Korean Medical Science, 28(6), 934-938.[PubMed][DOI]
  5. Rasheed, H., Mahgoub, D., Hegazy, R., El-Komy, M., Abdel Hay, R., Hamid, M. A., & Hamdy, E. (2013). Serum ferritin and vitamin d in female hair loss: do they play a role? Skin Pharmacology and Physiology, 26(2), 101-107.[PubMed][DOI]
  6. Sinclair, R. (2018). Frontal fibrosing alopecia: a review. Journal of Investigative Dermatology Symposium Proceedings, 19(1), S64-S66.[DOI]

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Frequently Asked Questions

How can I test my thyroid hormones at home?

You can test your thyroid hormones at home with SiPhox Health's Core Health Program, which includes TSH testing in the base panel. For comprehensive thyroid testing including Free T3, Free T4, and TPOAb, you can add the Thyroid+ expansion to get a complete picture of your thyroid function.

How long does it take for eyebrows to grow back after addressing the underlying cause?

Eyebrow regrowth typically takes 3-6 months once the underlying issue is properly treated. Hair follicles need time to transition from the resting phase back to active growth, and the complete hair growth cycle for eyebrows is about 4 months.

Can stress alone cause my eyebrows to thin on the outer edges?

Yes, chronic stress can trigger telogen effluvium, causing hair follicles to enter the resting phase prematurely. However, stress-related hair loss usually affects all eyebrow hair rather than just the outer third, so isolated outer eyebrow thinning more commonly indicates thyroid or nutritional issues.

What's the difference between normal aging and pathological eyebrow thinning?

Normal aging causes gradual, symmetrical thinning of the entire eyebrow over decades. Pathological thinning typically occurs more rapidly (months to years), often affects the outer third specifically, and may be accompanied by other symptoms like fatigue, skin changes, or hair loss elsewhere.

Should I stop plucking my eyebrows if they're already thinning?

Yes, give your eyebrows a break from plucking, waxing, or threading for at least 3-6 months. Repeated trauma to hair follicles can cause permanent damage. Focus on gentle grooming with a spoolie brush and trimming only if necessary while addressing the underlying cause.

This article is licensed under CC BY 4.0. You are free to share and adapt this material with attribution.

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Health Programs Lead, Health Innovation

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View Details
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Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

Ben Bikman, PhD

Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

View Details
Tash Milinkovic, MD

Tash Milinkovic, MD

Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

View Details
Tsolmon Tsogbayar, MD

Tsolmon Tsogbayar, MD

Health Programs Lead, Health Innovation

Dr. Tsogbayar leverages her clinical expertise to develop innovative health solutions and evidence-based coaching. Dr. Tsogbayar previously practiced as a physician with a comprehensive training background, developing specialized expertise in cardiology and emergency medicine after gaining experience in primary care, allergy & immunology, internal medicine, and general surgery.

She earned her medical degree from Imperial College London, where she also completed her MSc in Human Molecular Genetics after obtaining a BSc in Biochemistry from Queen Mary University of London. Her academic research includes significant work in developmental cardiovascular genetics, with her thesis publication contributing to the understanding of genetic modifications on embryonic cardiovascular development.

View Details
Pavel Korecky, MD

Pavel Korecky, MD

Director of Clinical Product Operations

Director of Clinical Product Operations at SiPhox Health with a background in medicine and a passion for health optimization. Experienced in leading software and clinical development teams, contributing to patents, launching health-related products, and turning diagnostics into actionable tools.

View Details
Paul Thompson, MD

Paul Thompson, MD

Advisor

Paul D. Thompson is Chief of Cardiology Emeritus of Hartford Hospital and Professor Emeritus at University of Connecticut Medical School. He has authored over 500 scientific articles on cardiovascular risk factors, the effects of exercise, and beyond. He received National Institutes of Health’s (NIH) Preventive Cardiology Academic Award, and has received NIH funding for multiple studies.

Dr. Thompson’s interests in exercise, general cardiology and sports cardiology originated from his own distance running: he qualified for the 1972 Olympic Marathon Trials as a 3rd year medical student and finished 16th in the 1976 Boston Marathon. Dr. Thompson publishes a blog 500 Rules of Cardiology where he shares lessons and anecdotes that he has learned over his extensive career as a physician, researcher and teacher.

View Details
Robert Lufkin, MD

Robert Lufkin, MD

Advisor

Physician/medical school professor (UCLA and USC) and New York Times bestselling author empowering people to take back their metabolic health with lifestyle and other tools. A veteran of the Today Show, USA Today, and a regular contributor to FOX and other network news stations, his weekly video podcast reaches over 500,000 people. After reversing chronic disease and transforming his own life he is making it his mission to help others do the same.

His latest book, ‘Lies I Taught In Medical School’ is an instant New York Times bestseller and has re-framed how we think about metabolic health and longevity. In addition to being a practicing physician, he is author of over 200 peer reviewed scientific papers and 14 books that are available in fourteen languages.

View Details
Ben Bikman, PhD

Ben Bikman, PhD

Advisor

Benjamin Bikman earned his Ph.D. in Bioenergetics and was a postdoctoral fellow with the Duke-National University of Singapore in metabolic disorders. Currently, his professional focus as a scientist and professor (Brigham Young University) is to better understand the role of elevated insulin and nutrient metabolism in regulating obesity, diabetes, and dementia.

In addition to his academic pursuits, Dr. Bikman is the author of Why We Get Sick and How Not To Get Sick.

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Tash Milinkovic, MD

Tash Milinkovic, MD

Health Programs Lead, Heart & Metabolic

Dr. Natasha Milinkovic is part of the clinical product team at SiPhox Health, having graduated from the University of Bristol Medical School. Her medical career includes rotations across medical and surgical specialties, with specialized research in vascular surgery, focusing on recovery and post-operative pain outcomes. Dr. Milinkovic built her expertise in emergency medicine as a clinical fellow at a major trauma center before practicing at a central London teaching hospital throughout the pandemic.

She has contributed to global health initiatives, implementing surgical safety standards and protocols across rural Uganda. Dr. Milinkovic initially joined SiPhox Health to spearhead the health coaching initiative and has been a key contributor in the development and launch of the Heart and Metabolic program. She is passionate about addressing health disparities by building scalable healthcare solutions.

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